How America Has Racialized Medicine During Epidemics
Just a month ago, there was chatter about how African Americans have a unique racial immunity to the novel coronavirus. Now that data is emerging that African Americans are actually contracting Covid-19 at alarming rates, the new chatter is just the opposite: that African Americans instead have a unique racial vulnerability to it. While there are many potential good explanations for this disparity, including racism in the health care system, much of the focus has been instead on black people’s behaviors as the cause. In a recent press conference, U.S. Surgeon General Jerome Adams, an African American, addressed the disparity in black deaths by scolding black people to “step up” their social distancing game while chiding them about avoiding alcohol, tobacco, and drugs.
There is unfortunately a long, sordid history in the medical world of holding black people responsible for poor health outcomes, despite the racial discrimination they have encountered in doctor’s offices and hospitals. Connecticut College gender and women’s studies professor Mab Segrest explores this history in her new book, “Administrations of Lunacy: Racism and the Haunting of American Psychiatry at the Milledgeville Asylum.”
The asylum in the title is the Georgia State Lunatic, Idiot, and Epileptic Asylum in Milledgeville, Georgia, (today called the Central State Hospital) which opened in 1841 and became the largest mental health institution in the world in the 1960s before shuttering in 2010 (though one remaining building from its mammoth 2,000-acre plot still takes some patients from jails and prisons).
Segrest explores how the hospital's chief superintendent in the 1880s, Theophilus O. Powell, began developing medical theories that became foundational for U.S. disease outbreak response policies. His ideas also became the underpinning for theories on innate racial vulnerability — that black people are culturally, intellectually, and genetically inferior — as a way of explaining racially disparate health outcomes. When the black patient population began escalating in the Milledgeville Asylum in the late 19th century, Powell said emancipation was driving African Americans insane, because they no longer had access to what was then considered “the hygienic effects of slavery.”